Personal and public choices eroding health

The surge in NCDs in India stems as much from today’s hectic lifestyle as from unplanned urban development.

Updated - December 04, 2021 10:59 pm IST

Published - August 13, 2016 01:13 am IST

Non-communicable diseases (NCDs) linked to lifestyles have surpassed communicable diseases as the leading cause of lost productivity and premature deaths.

According to a report in the Lancet journal, NCDs contribute to 52 per cent of all disease burden and more than 60 per cent of deaths in the country.

Cardiovascular diseases, cancer, tuberculosis and other causes linked to tobacco consumption result in over a million deaths every year.

Tobacco-related deaths are expected to double by 2030, nearly 65 million Indians have been diagnosed with diabetes, and research suggests the “average age of a person having their first heart attack is 50 years, at least ten years earlier than in developed countries.”

Responding to this escalating situation the Central Government has come up with a National Action Plan and Monitoring Framework for Prevention and Control of NCDs. Given the rising toll of “lifestyle” diseases, the Minister of State for Health, Faggan Singh Kulaste told the Lok Sabha on July 22 that “operational guidelines” have been issued this year for population-level screening to detect diabetes, hypertension and common cancers.

The guidelines focus on triggers for these diseases found in the choices that people make, but it is not clear how such an ambitious scheme would actually work at the level of the entire population, since the lead would have to be taken by State governments.

Lifestyle risk factors are everyday choices in some cases, but they are also the outcome of poorly conceived official policies.

Smoking or chewing tobacco, excessive consumption of alcohol, and a preference for highly processed foods are voluntary choices with a direct, harmful impact on health.

But what choice do citizens have, if cities expand at the cost of walking, exercising and cycling? If city governments are more sensitive to petrol and diesel prices, and road building than to pedestrian facilities and public transport?

Such cities end up curbing healthy physical activity and promoting car use, adding to the burden of air pollution caused by burning of biomass and unchecked construction dust.

Bad urban planning thus produces a cocktail of risk factors for NCDs, affecting millions.

Cities have not read the warning yet. Public spaces lack green cover, and low-cost access to roads and parking for a large number vehicles is given priority.

Policymakers must alter course through progressive steps.

The cost of inaction will certainly be high.

Changing profile of hospital patients reflects a sharp rise in cardiovascular, endocrine disorders.

This is the sixth and final part of the series, Malady Nation, on India's multi-dimensional healthcare crisis. This part explains the alarming trends in lifestyle diseases and their link to individual choice and public policy.


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